Asian ancestry was associated with a higher 10-year predicted risk of type 2 diabetes (13.2% vs. 8.5%; P<0.001) and greater insulin resistance compared to European ancestry.
Cross-Sectional (n=448)
Does Asian ancestry compared to European ancestry associate with higher predicted 10-year T2DM risk, greater insulin resistance, and lower β-cell function in individuals without diabetes?
Individuals of Asian ancestry without diabetes have a higher predicted 10-year risk of T2DM, driven by greater insulin resistance and lower β-cell function compared to those of European ancestry.
Absolute Event Rate: 13.2% vs 8.5%
p-value: p=<0.001
Introduction and Objective: Individuals of Asian (ASN) ancestry are at higher risk of type 2 diabetes mellitus (T2DM) than those of European (EUR) ancestry. Insulin resistance and β-cell dysfunction increase the risk of T2DM. However, it is uncertain whether individuals of ASN ancestry have lower β-cell function at a given degree of insulin resistance than those of EUR ancestry. Methods: We studied 448 individuals without diabetes (125 ASN and 323 EUR). We calculated the 10-year estimated risk of T2DM using the QDiabetes-2018 risk prediction algorithm. We directly measured insulin resistance by steady-state plasma glucose (SSPG) concentration during the Insulin Suppression Test and β-cell function by fasting C-peptide concentration. We stratified individuals by median SSPG concentration into insulin resistant (IR; above median) and insulin sensitive (IS; below median) groups. Results: The mean ± standard deviation age of participants was 50 ± 10 years, and 58% were women. The 10-year QDiabetes risk was higher in ASN participants than in those of EUR ancestry (13.2 ± 17.3% vs. 8.5 ± 9.9%; P 0.001). SSPG concentration was also higher in ASN participants than in those of EUR ancestry (169 vs. 137 mg/dL; P 0.01, adjusted for age, sex, and BMI). Among all participants, for each 30-unit increase in SSPG concentration, QDiabetes risk increased by 2.4% (P 0.001). In the IR group, SSPG concentration was similar (202 ± 41 vs. 201 ± 41 mg/dL; P = 0.87), but fasting C-peptide concentration was lower (1.99 vs. 2.29 ng/mL; P = 0.02) in ASN participants than in those of EUR ancestry. Conclusion: Individuals of ASN ancestry have higher 10-year diabetes risk and greater degree of insulin resistance compared to those of EUR ancestry. Among IR individuals, despite a similar degree of insulin resistance, ASN individuals have lower β-cell function than those of EUR ancestry. Evaluation of both insulin resistance and β-cell function in ASN individuals may help address diabetes risk and its reduction through therapies that improve insulin resistance and β-cell function. Disclosure A. Aldulimy: None. F. Abbasi: None. J. Knowles: Consultant; Current; Wave Biosciences, Mammoth. Funding Accelerate Innovation in Diabetes LeVeraging Unique PAthways iN Asians Program (ADVANCE)
Aldulimy et al. (Fri,) conducted a cross-sectional in Type 2 diabetes risk (n=448). Asian ancestry vs. European ancestry was evaluated on 10-year estimated risk of T2DM using QDiabetes-2018 (p=<0.001). Asian ancestry was associated with a higher 10-year predicted risk of type 2 diabetes (13.2% vs. 8.5%; P<0.001) and greater insulin resistance compared to European ancestry.